We're Here For Mrs. Doe

Perhaps my company was more interested in making a few extra bucks than providing the lady with the appropriate service. What’s more, taxpayers were footing some part of the bill for those ambulance rides.

It was recently reported that Rural/Metro, a private ambulance company that operates nationally, had been accused of overcharging the City of San Diego by as much as $12 million over the past ten years. If this sort of allegation can happen with a company described in media reports as a “one-of-a-kind model for how a public-private partnership can work to save lives,” I guarantee that many other less reputable companies are conducting business no differently.

The woman in the wheelchair at Paradise Valley Hospital’s ER posed a significant problem, as the ambulance is not equipped to transport patients in chairs. We could have transported her and left the wheelchair behind, but nobody would’ve liked that idea. The only option was to transport the patient with her chair.

Our company had a separate division — two vans dedicated to transporting patients like this. A couple of minutes after we realized our issue, one of the wheelchair-van drivers came strolling up and informed us that he had been called to transport our patient.

My partner and I were ecstatic. Dispatch must have sent us the call by accident, and we were going to get canceled. I preemptively began loading the gurney into the ambulance while my partner went to make the call. Just as I’d slammed the back doors and started for the medic room for free snacks, my partner approached me with a death stare.

“Pull the gurney back out,” he growled.

“Why?”

My partner was a 21-year-old kid with the soul of a 45-year-old drill instructor. He came from a long line of firefighters but had little interest in carrying on with the family business. As a college graduate — rare for an EMT — he wanted to serve his country and become a Navy SEAL.

Dispatch had instructed us to transport the patient, after all. The other driver was to transport the chair.

My partner had argued with dispatch. “Why would we do a thing like that?”

“Don’t ask questions” was the response.

I grumbled and unlocked the gurney, letting all 75 pounds roll out of the van. We went back into the ER, informed the wheelchair driver of the plan, loaded up the patient, and transported her.

After pulling the van into a constricted alleyway, we arrived at the patient’s house and devised a plan to get the gurney inside. The tight entry leading to the front door made it impossible to go in that way. The only other option was a side door with four or five steps below it. This would not be an easy task, but we had an extra person to help us.

I was at the head of the gurney, while my partner and the wheelchair driver were at the foot. The plan was for my partner and the wheelchair driver to lift their end; I would gradually lift the head up one step at a time. Things were going fine until the lady freaked out and started yelling, “You’re going to drop me, you’re going to drop me!” She reached over the side of the gurney, grasping for fistfuls of air, as if that would circumvent gravity.

As the 250-pound woman and the gurney began to rotate, my entire EMS career flashed before my eyes. I saw it all — the lady falling, the investigation, the lawsuit, and the dramatic final scene, where my manager stands with her arms angrily set on her hips. “Badge and pager,” she demands. At which point, my partner and I toss them on her cluttered desk.

With every bit of strength we had, we were able to compensate for the woman’s displaced weight. We got the lady and the gurney stabilized.

We carefully maneuvered the gurney back out through the narrow hallway, trying to not scratch the wall. Meanwhile, the same lady we’d all but broken our backs for walked to the kitchen to grab a snack.

As traumatic as the whole situation was, what really bothered me was something on the patient’s information sheet. Under the payer’s information, it read “Medicare.” I don’t have the evidence to decisively say who got charged what, but I can’t help feeling that the taxpayer-funded system would be double-charged for unnecessary services.

After two years with these ambulance companies, I lost faith in what I was doing. I’d gotten into the EMS business to help people, but working for a basic life support company, I rarely felt that way. Every workday was a strain on my conscience. I knew I was providing a service to many people who did not need it. I was merely making money for a company I did not like, one that passed most of the bill off to California taxpayers.

I would like to make it clear that I support the paramedics, intermediates, basics, firefighters, and nurses who choose to do a job that comes with a mountain of responsibility and little gratitude. I hope this comes to mind next time there are two EMTs in the back of a Starbucks line, anxiously awaiting their turn to order 20 ounces of much-needed caffeine. Please do the right thing and wave them ahead. ■

Comments

Excellent written article. May I remind you though, that in a life threatening emergency its quite unfair to assume that an EMTs only tool is the cell phone with which to call 911? I don't need to enumerate the interventions an EMR can make as it seems you are aware of those but it seems you have forgotten your BLS basics in that a well trained EMT is worth their weight in life saving measures regardless if their scope is elementary, as it seems, to you. Anyone can call 911. Anyone can flip burgers. And burger flippers get paid more than most EMTs. So show a little respect for us little people. In a crisis we are watching out for the paramedics or nurses back while helping for the best patient outcome. I feel sorry for any EMT who works with you and all they get to do is call 911, instead of doing what they were trained to do.

I really enjoyed reading this! I've often wondered what it was like to be an EMT and I am appalled to see how little they are paid! I had no idea, but if it were up to me, I'd double it and I hope someday companies like the one you wrote about will be more concerned with efficiency and patient and employee care than their bottom line. Thanks for sharing and I'd buy you a Venti if I could!!!